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The need to build on recent progress

Chart 4: Density of radiation oncologists and clinical oncologists per 1,000 population

Source: WHO (radiation oncologists), EIU reseach (clinical oncologists).

0.000

0.005

0.010

0.015

0.020

0.025

0.030

0.035

0.040

Radiation oncologists Clinical oncologists

Uruguay

Pe

ru

Pa

Me Panama raguay

xico

Ecuador

Co

Colombia sta Rica

Bolivia Brazil Chile

Ar

gentina

no data

An important aspect of care delivery is the

availability of medicines. In terms of the

availability of medicines from the WHO

Essential Cancer Drug List in the public health

system, cisplatin, fluorouracil, docetaxel,

imatinib, rituximab and trastuzumab were

considered. Most countries show evidence

of at least codifying them in the national

medicines framework or formulary. But actual

availability is difficult to asses. Availability tends

to be better in large urban centres and capitals

than in provinces, experts suggest. Buying and

distribution processes may also be complex,

as in Brazil. “Pertuzumab was supposed to be

available in June 2018, but to date no one has

received it,” notes Dr Simon. Paraguay and

Bolivia presented the lowest availability overall,

missing two or more of these medicines.

Additionally, The Economist Intelligence Unit

examined the degree of reimbursement

available for cancer medicines. Although all

countries offer cancer treatment without

co-pay in public healthcare schemes, in

Bolivia, Chile, Mexico and Peru, for example,

some types of cancer are excluded. But

even if treatment is nominally available for

all cancers, there is no guarantee that these

will be the best treatments possible. For

instance, the range of medicines available in

public healthcare schemes may not always

incorporate the latest innovations. As an

example, in Ecuador, it took five years to

update the national medicines framework.

However, a new version was presented in

August 2019.^69

(^69) Redacción Médica, Ecuador incorpora 64 nuevos fármacos en la actualización del Cuadro Nacional de Medicamentos Básicos, 2019.